No abstract

Background This study examined the relationship of medication adherence to frequency of pulmonary exacerbation and rate of decline in FEV1% predicted (FEV1). Methods 95 CF patients ages 6 years or older and prescribed a pulmonary medication, enrolled in a longitudinal retrospective review of medication adherence and health outcomes (the occurrence and frequency of intravenous (IV) antibiotic treatments and FEV1) over 12-months. Pharmacy refill records were used to calculate a medication possession ratio (MPR). Results Composite MPR predicted the occurrence of at least one pulmonary exacerbation requiring a course of IV antibiotics (IRR=2.34, p=0.05), but not the frequency of exacerbations, after controlling for gender, baseline FEV1, and regimen complexity. Composite MPR predicted baseline FEV1 (estimate=29.81, p=.007), but not decline in FEV1. Conclusions These results demonstrate a significant relation between medication adherence and IV antibiotics in CF patients, highlighting the importance of addressing adherence during clinic visits to improve health outcomes.

Health literacy is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (1-4) and is most often measured by reading comprehension of health-related information (5, 6). Multiple studies indicate that inadequate health literacy is associated with worse health status and higher rates of hospitalization across a number of patient populations (4,7,8), including patients with diabetes mellitus, patients with HIV infection, and the elderly (9-12). However, there are relatively few data about the effects of inadequate health literacy in patients with asthma, a common chronic respiratory disorder affecting 5 to 10% of the U.S. population (13).